Mario Tranfa1, Mario Tortora1, Giuseppe Pontillo2,3, Valentina Iuzzolino4, Eleonora Riccio5, Simona Caccavallo6, Teodolinda Di Risi6,7, Serena Monti8, Roberta Lanzillo4, Vincenzo Brescia Morra4, Giuseppe Palma8, Maria Petracca4,9, Antonio Pisani6, Arturo Brunetti1, Sirio Cocozza1. 1. Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, Italy. 2. Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80131, Naples, Italy. giuseppe.pontillo@unina.it. 3. Department of Electrical Engineering and Information Technology, University of Naples "Federico II", Naples, Italy. giuseppe.pontillo@unina.it. 4. Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy. 5. Institute for Biomedical Research and Innovation, National Research Council of Italy (IRIB CNR), Palermo, Italy. 6. Department of Public Health, Nephrology Unit, University "Federico II", Naples, Italy. 7. CEINGE - Advanced Biotechnologies, Naples, Italy. 8. Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy. 9. Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
Abstract
OBJECTIVES: Although the use of specific MRI criteria has significantly increased the diagnostic accuracy of multiple sclerosis (MS), reaching a correct neuroradiological diagnosis remains a challenging task, and therefore the search for new imaging biomarkers is crucial. This study aims to evaluate the incidence of one of the emerging neuroradiological signs highly suggestive of MS, the central vein sign (CVS), using data from Fabry disease (FD) patients as an index of microvascular disorder that could mimic MS. METHODS: In this retrospective study, after the application of inclusion and exclusion criteria, MRI scans of 36 FD patients and 73 relapsing-remitting (RR) MS patients were evaluated. Among the RRMS participants, 32 subjects with a disease duration inferior to 5 years (early MS) were also analyzed. For all subjects, a Fazekas score (FS) was recorded, excluding patients with FS = 0. Different neuroradiological signs, including CVS, were evaluated on FLAIR T2-weighted and spoiled gradient recalled echo sequences. RESULTS: Among all the recorded neuroradiological signs, the most striking difference was found for the CVS, with a detectable prevalence of 78.1% (57/73) in RRMS and of 71.4% (25/32) in early MS patients, while this sign was absent in FD (0/36). CONCLUSIONS: Our results confirm the high incidence of CVS in MS, also in the early phases of the disease, while it seems to be absent in conditions with a different etiology. These results corroborate the possible role of CVS as a useful neuroradiological sign highly suggestive of MS. KEY POINTS: • The search for new imaging biomarkers is crucial to achieve a correct neuroradiological diagnosis of MS. • The CVS shows an incidence superior to 70% in MS patients, even in the early phases of the disease, while it appears to be absent in FD. • These findings further corroborate the possible future central role of CVS in distinguishing between MS and its mimickers.
OBJECTIVES: Although the use of specific MRI criteria has significantly increased the diagnostic accuracy of multiple sclerosis (MS), reaching a correct neuroradiological diagnosis remains a challenging task, and therefore the search for new imaging biomarkers is crucial. This study aims to evaluate the incidence of one of the emerging neuroradiological signs highly suggestive of MS, the central vein sign (CVS), using data from Fabry disease (FD) patients as an index of microvascular disorder that could mimic MS. METHODS: In this retrospective study, after the application of inclusion and exclusion criteria, MRI scans of 36 FD patients and 73 relapsing-remitting (RR) MS patients were evaluated. Among the RRMS participants, 32 subjects with a disease duration inferior to 5 years (early MS) were also analyzed. For all subjects, a Fazekas score (FS) was recorded, excluding patients with FS = 0. Different neuroradiological signs, including CVS, were evaluated on FLAIR T2-weighted and spoiled gradient recalled echo sequences. RESULTS: Among all the recorded neuroradiological signs, the most striking difference was found for the CVS, with a detectable prevalence of 78.1% (57/73) in RRMS and of 71.4% (25/32) in early MS patients, while this sign was absent in FD (0/36). CONCLUSIONS: Our results confirm the high incidence of CVS in MS, also in the early phases of the disease, while it seems to be absent in conditions with a different etiology. These results corroborate the possible role of CVS as a useful neuroradiological sign highly suggestive of MS. KEY POINTS: • The search for new imaging biomarkers is crucial to achieve a correct neuroradiological diagnosis of MS. • The CVS shows an incidence superior to 70% in MS patients, even in the early phases of the disease, while it appears to be absent in FD. • These findings further corroborate the possible future central role of CVS in distinguishing between MS and its mimickers.
Authors: Andrew J Solomon; Roman Pettigrew; Robert T Naismith; Salim Chahin; Stephen Krieger; Brian Weinshenker Journal: Mult Scler Date: 2020-03-12 Impact factor: 6.312
Authors: Alan J Thompson; Brenda L Banwell; Frederik Barkhof; William M Carroll; Timothy Coetzee; Giancarlo Comi; Jorge Correale; Franz Fazekas; Massimo Filippi; Mark S Freedman; Kazuo Fujihara; Steven L Galetta; Hans Peter Hartung; Ludwig Kappos; Fred D Lublin; Ruth Ann Marrie; Aaron E Miller; David H Miller; Xavier Montalban; Ellen M Mowry; Per Soelberg Sorensen; Mar Tintoré; Anthony L Traboulsee; Maria Trojano; Bernard M J Uitdehaag; Sandra Vukusic; Emmanuelle Waubant; Brian G Weinshenker; Stephen C Reingold; Jeffrey A Cohen Journal: Lancet Neurol Date: 2017-12-21 Impact factor: 44.182
Authors: Martina Absinta; Maria A Rocca; Bruno Colombo; Massimiliano Copetti; Donatella De Feo; Andrea Falini; Giancarlo Comi; Massimo Filippi Journal: J Neurol Date: 2012-06-20 Impact factor: 4.849
Authors: Caterina Lapucci; Laura Saitta; Giulia Bommarito; Maria Pia Sormani; Matteo Pardini; Laura Bonzano; Giovanni Luigi Mancardi; Claudio Gasperini; Antonio Giorgio; Matilde Inglese; Nicola De Stefano; Luca Roccatagliata Journal: Neurology Date: 2019-03-08 Impact factor: 9.910